Living with an indwelling urethral catheter in a community setting: exploring triggers for unscheduled community nurse "out of hours" visits

Abstract

Aims and Objective  To explore the experiences of community patients living with a urethral catheter and those caring for them.  Background  Living at home with an indwelling urethral catheter often results in consequences that create a double-edged burden; firstly, on patients and their relative carers, and secondly in terms of unscheduled community nurse service ‘out of hours’ provision. Design  One-to-one interviews, were conducted with patients living at home, their relative carers, qualified community nurses, augmented home carers, and health care assistant. Quantitative data in relation to frequency, duration and reason for visits were extracted from the community nurse ‘out of hours’ service database.  Results  Quantitative data showed that 20% of all community nurses, unscheduled ‘out of hour’ visits were triggered by an indwelling urethral catheter consequence. Qualitative data revealed that health and social care staff felt knowledgeable and skilled in urethral catheter management. Conversely, patients and relative carers felt poorly equipped to manage the situation when something went wrong. The majority of patients described the catheter as being a debilitating source of anxiety and pain that reduced their quality of life.  Conclusion  Urethral catheter complications are frequent and impact seriously on quality of life with informal carers also affected. Community nurses experienced frequent unscheduled visits. Patients often feel isolated as well as lacking in knowledge, skills and information on catheter management. Having better urethral catheter information resources could increase patient and relative carer confidence, encourage self-care and problem solving, as well as facilitate meaningful consistent dialogue between patients and those who provide them with help and support.  Relevance to Clinical Practice  Better patient information resources regarding urethral catheter management have potential to improve patient and relative carer quality of life and reduce service provision burden.